Information about patient quality of life and pain management are especially important data points to collect, spine surgeons say.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.
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Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CST Wednesday, July 31.
Editor's note: Responses were lightly edited for clarity and length.
Question: What is one data point all spine surgeons should take note of in their patient care?
Neel Anand, MD. Cedars-Sinai Spine Center (Los Angeles): It is absolutely essential that we as spine specialists listen carefully to what our patients tell us. Let their emotional and physical experiences be our guide. In fact, they usually give us the diagnosis and set expectations for their treatment and recovery. This input should never be ignored or discounted because it provides us a foundation from which we can provide a definitive diagnosis and tailored treatment plan that will enable them to return to the activities they enjoy.
Rachel Bratescu, MD. Weill Cornell (New York City): One data point that all spine surgeons should take note of in their patient care is total anesthesia time, or the continuous period from start to end of anesthetic delivery. What makes this measure so valuable for surgeons has to do with optimizing efficiency. There are a myriad of contributing factors, presenting multiple opportunities for improving operating room efficiency and in some cases patient outcomes. Those in surgeon-control include things such as opting for co-surgery for complex deformity cases, meticulous surgical planning and anticipating equipment/implant needs to reduce delays intraoperatively. From an individual and team standpoint a standardized workflow is also essential. Any of these measures can help decrease physiologic burden of general anesthesia and in particular for high-risk patients, total anesthesia time and blood loss.
Brian Fiani, DO. Mendelson Kornblum Orthopedic & Spine Specialists (West Bloomfield, Mich.): Outcome metrics are very important and one data point that spine surgeons should take note of in their patient care is the patient's postoperative pain levels. It is very important to monitor the functional outcomes. Monitoring and tracking these metrics can help assess the success of the surgery and make any necessary adjustments to the treatment plan.
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: The amount of and frequency of pain medications and VAS pain scores. Also important is recording how much gabapentin or Lyrica patients are taking. You really don’t know how well you did until you can track those amounts.
James Nguyen, MD. Providence St. Joseph Medical Center (Burbank, Calif.): Outcomes in spine surgery can be complex and involve numerous data points. In my practice, we focus on health-related quality of life assessments and scores. Improvement in activities of daily living, although difficult to assess, is critical in determining the value of spine surgery and the effectiveness of our interventions. Spine surgery is often elective, and reduction of suffering/disability and improvement of quality of life are usually the reasons many patients choose to undergo treatment.
Jeremy Smith, MD. Hoag Orthopedic Institute (Newport Beach, Calif.): One critical data point that all spine surgeons should prioritize in their patient care is the patient's functional status and quality of life. This includes assessing and monitoring how the patient's condition impacts their daily activities, pain levels, mobility, and overall well-being. By focusing on these aspects, surgeons can tailor their treatment plans to not only address the anatomical issues but also enhance the patient's ability to perform everyday tasks and improve their life satisfaction. Functional assessments, patient-reported outcome measures, and regular follow-ups can provide valuable insights into the effectiveness of interventions and guide adjustments to optimize long-term outcomes.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): EHR's provide a plethora of useful and not so useable patient metrics, yet measuring specifics such as patient readmission and acute returns to the operating room potentially categorizes competency and may portend one's forthcoming. The continuum of care in complex spinal surgery can lead to better outcomes and patient satisfaction as it encompasses both patient engagement and satisfaction. As routine follow ups are conventional wisdom and the gold standard for patient outcomes, additional result reporting and patient interdiction of those visits and communications presage further/expedited treatment algorithms and satisfaction criteria, if required subsequently.